Atherectomy device for severe occlusions

An atherectomy device for removal of material of an atheroma from a vessel, said device comprising:

• a flexible tubular member adapted to be inserted into the vessel and having proximal and distal extremities,
• flexible drive means having proximal and distal extremities disposed within said tubular member for rotational and axial movement in the tubular member, said drive means being tubular and having a passage extending longitudinally therethrough,
• a cup-shaped cutter carried by the distal extremity of the flexible drive means, said cutter having a distally extending annular cutting surface and an interior collection chamber,
• means carried by the proximal extremity of the flexible tubular member and coupled to the flexible drive means for rotating the cutting device independent of rotation of the tubular member and for axially extending and retracting the cutter independent of axial movement of the tubular member,
• a flexible guide wire mounted for axial movement in the passage in the drive means, said guide wire extending forward of the cutter, and
• retaining means carried by the guide wire for facilitating collection of materials removed from the atheroma by the cutter.

An atherectomy device for removal of material of an atheroma from a vessel, said device comprising:

• a flexible tubular member adapted to be inserted into the vessel and having proximal and distal extremities,
• a flexible drive means disposed within the tubular member for rotational and axial movement therein.
• a cup-shaped cutter carried by the flexible drive means, said cutter having a distally extending annular cutting surface and an interior collection chamber,
• a flexible guiding wire extending forward of the cutter for guiding the cutter to travel axially within the vessel, and
• anchoring means carried by the guide wire forward of the cutter for pressing radially to resist slippage by the cutter as it cuts through the atheroma.

An atherectomy device for removing material of an atheroma from a vessel, said device comprising:

• a flexible tubular member adapted to be inserted into the vessel and having proximal and distal extremities,
• a flexible drive means having proximal and distal extremities and disposed within said tubular member for rotational movement within the tubular member,
• a tubular collection chamber secured to the distal extremity of the flexible drive means, said chamber having an open distal end and a substantially closed proximal end,
• an annular cutting ring secured to the tubular collection chamber, whereby material severed by the ring can enter the collection chamber,
• a sheath for receiving said cutting means such that at least a portion of the cutting edge is not exposed,
• actuator means carried by the proximal extremity of the flexible tubular member and coupled to the flexible drive means for rotating the cutting device independent of rotation of the tubular member,
• translating means for simultaneously moving said cutting means and said sheath relative to said tubular member,
• flexible guiding means extending forward of the cutter for guiding the cutter to travel axially within the vessel, and
• retention means carried by the guiding means forwardly of the cutting means for cooperating with the collection means to collect removed atheroma material within the atherectomy device.

An atheroma device for removal of material of an atheroma from a vessel, said device comprising:

• a flexible tubular member adapted to be inserted into the vessel,
• a flexible drive means disposed within the tubular member for rotational and axial movement therein,
• a cup-shaped cutter carried by the flexible drive means, said cutter having a forwardly extending annular cutting surface and an interior collection chamber,
• a flexible guiding wire extending forward of the cutter for guiding the cutter to travel axially within the vessel,
• retention means carried by the guide wire forward of the cutter for collecting the removed atheroma material within the atherectomy device,
• said retention means including an expandable member.

An atheroma device for removal of material of an atheroma from a vessel, said device comprising:

• a flexible tubular member,
• a tubular flexible drive means disposed within said tubular member for rotational movement in the tubular member,
• a cup-shaped cutter carried by the distal extremity of the flexible drive means, the cutter having a forwardly extending annular cutting surface and an interior collection chamber,
• a flexible guide wire disposed within the drive means and mounted for axial movement therein, said guide wire extending beyond the distal extremity of the cutter, and being rotationally decoupled therefrom,
• a retention means carried by the guide wire distally to the cutter for facilitating collection of materials removed from the atheroma by the cutter, and
• means for translating the cutter and the retention means relative to each other.

A method for removing at least a portion of an atheroma from a blood vessel, the method comprising the steps of:

• advancing a guide wire into the vessel to a position so that at least a portion of an expandable member carried by the guide wire is positioned distally to the portion of the atheroma to be removed;
• advancing a cutter over the guide wire through the atheroma towards the expandable member for removing a portion of the atheroma;
• expanding the expandable member within the vessel in the radial direction;
• and
• bringing the cutter into contact with the expanded expandable, whereby the atheroma is severed.

A method for removing at least a portion of an atheroma from a blood vessel, the method comprising the steps of:

• advancing a guide wire into the vessel to a position in the vicinity of the atheroma to be removed;
• advancing a cup-shaped cutter over the guide wire into the vessel to a position proximal to the portion of the atheroma to be removed, said cutter having an annular cutting surface and an interior collection chamber;
• and
• simultaneously rotating and advancing the cutter, the advancement causing the cutter to egress from the housing, whereby the atheroma is severed and the severed portions of atheroma are collected in the collection chamber.

In a method for removing at least a portion of an atheroma from a vessel using an atherectomy device having a flexible tubular member, a cutter carried by the distal extremity of a flexible tubular drive means disposed within the tubular member and mounted for rotational movement therein, a flexible guide wire passing axially through the tubular drive means and adapted for axial movement therein, the guide wire carrying a retention means near its distal extremity, the method comprising the steps of:

• inserting the guide wire and retention means into the vessel;
• advancing the retention means within the vessel to a desired position proximal to the atheroma materials to be removed;
• guiding the cutter to a position within the vessel that is a selected distance proximal to the retention means;
• rotating the cutter while simultaneously advancing the retention means and the cutter through the atheroma for removing a portion of the atheroma while maintaining the fixed spacing;
• collecting the removed portions of atheroma;
• drawing the retaining means into abutment with the cutter for retention of the collected atheroma materials within the atherectomy device;
• and
• withdrawing the cutter and retention means carrying the collected portions of atheroma from the vessel.

In a method for removing at least a portion of an atheroma from a vessel using an atherectomy device having a flexible tubular member, a cutter carried by the distal extremity of a flexible tubular drive means disposed within the tubular member and mounted for rotational movement therein, a flexible guide wire passing axially through the tubular drive means and adapted for axial movement therein, the guide wire carrying an expandable member near its distal extremity, the method comprising the steps of:

• inserting the guide wire and expandable member into the vessel;
• advancing the expandable member within the vessel to a first desired position relative to the atheroma materials to be removed;
• guiding the cutter to a second desired position within the vessel that is proximal to the atheroma materials to be removed;
• expanding the expandable member to anchor the atherectomy device at a position distal to the cutting assembly;
• simultaneously rotating and advancing the cutter to remove a portion of the atheroma;
• collecting the removed portions of atheroma;
• drawing the expandable member into abutment with the cutter for retaining the collected atheroma materials within the atherectomy device;
• and
• withdrawing the collected portions of atheroma from the vessel.